Kelly J Hwang, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

61930 Issued in CA

Practice address

141 N Main St
Lake Elsinore, CA 92530-4118

Phone

(951) 245-5003

Fax

(951) 471-0637

NPI assigned

Jul 17, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kelly J Hwang DDS Inc

  • Dentist
  • San Diego, CA
  • NPI 1477068930
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1790030633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304118",
            "telephone_number": "951-245-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304118",
            "telephone_number": "951-245-5003",
            "fax_number": "951-471-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28225",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Huang, DDS
• Yu-Wei Huang, DDS
• Christie Michelle Hubbard, MSW
• Teresa Hunter, C.A.S.
• Amanda Hurst, PT, DPT, ATC
• Kailey Hyatt
• Marian Ibraheam
• Imperial Medical Managemenr, Inc.
• In-Home Non-Emergency Treatment Team
• In-Home Senior Care Services LLC

• Dentist in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.